| NPI | 1386638880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 34216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 39429) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2020-06-02 |